An article reviews the commonly used diuretics in nephrology

Diuretics are a commonly used antihypertensive drug in clinical practice, with the advantages of low cost and quick effect. Scholars have found that diuretics also have a good therapeutic effect on some patients with kidney disease. Subsequently, they have been used in diseases such as glomerulonephritis, nephrotic syndrome, and renal insufficiency. They are easy to use and have a definite effect. They have been used for many years. However, are diuretics really harmful to the kidneys? An endless stream of real cases tells us that the answer is no! Excessive diuretics will increase the burden on the kidneys, and in severe cases, it can even lead to renal failure. Therefore, it is particularly important to choose appropriate diuretics according to the patient's condition and use them rationally in the treatment of kidney disease.

What are the commonly used diuretics?

Diuretics are widely used in clinical practice and can be used to treat sodium and water retention in the body caused by various reasons. Diuretics mainly act on the kidneys to promote the excretion of sodium and water, and have become indispensable drugs for the treatment of kidney disease, cardiovascular and cerebrovascular diseases, etc. We divide them into 5 categories based on the site of action, chemical structure or mechanism of action, as follows:

How do patients with kidney disease choose diuretics?

When using diuretics, we usually have to make rational choices based on the type of disease and renal function level of the kidney patient. For patients with normal renal function or mild damage, the choice will naturally be relatively large. For patients with mild kidney disease, thiazide diuretics can be selected, and the doctor's instructions should be followed when taking the medicine. For patients with more severe renal insufficiency, loop diuretics are generally selected, and the dosage should be strictly controlled. For patients who have already developed ascites, two or more diuretics can be used in combination for better results.

In addition, appropriate diuretics should be selected according to the patient's specific symptoms. If the patient has hypertension, chlorthalidone or indapamide should be the first choice, which can reduce blood pressure and diuresis at the same time. If the patient has proteinuria, hydrochlorothiazide can be selected, and potassium-sparing diuretics can be used together if necessary. If edema occurs, a more effective loop diuretic such as furosemide can be selected, which can achieve the purpose of diuresis and swelling, and can be used in combination with other diuretics if necessary. What should kidney patients pay attention to when using diuretics?

1. When using diuretics, patients with kidney disease must use them under the guidance of a doctor and should not adjust the dosage without authorization to avoid fluctuations in their condition.

2. While taking diuretics, patients with kidney disease should pay attention to monitoring electrolytes and renal function indicators to prevent electrolyte disorders.

3. If the patient has nephrotic syndrome and obvious hypoproteinemia, do not blindly increase diuresis, as this may easily induce thrombosis and even increase the risk of acute kidney injury.

4. Avoid smoking, drinking, and strenuous exercise during medication. It is advisable to choose jogging, brisk walking, Tai Chi and other exercise methods.

5. If obvious hyperglycemia, hyperuricemia, etc. occur during medication, seek medical attention promptly and receive symptomatic treatment based on the specific condition.